Evaluation of Discharge Rate and its Influencing Factors on Patients in a Private Hospital in Tabriz in the First Half of 1391

​Background and objectives : Discharge Against Medical Advice (DAMA) is the common problem of the health care systems. DAMA also increases the mortality, morbidity and disease exacerbation. Understanding the reasons that patients choose DAMA has an important role in reducing mortality and morbidity rate and also reduces hospital costs. This study aimed to investigate the rate and causes of DAMA in patients in a private hospital in Tabriz city in the first half of 1391. Material and Methods : This descriptive-analytical study was conducted in a cross-sectional form in 1392 in one of the private hospitals in Tabriz city. Study population consisted of all patients with DAMA in the first half of 1391. To collect data, a valid and reliable check list made by researcher was used. Data were entered into SPSS 17 software. Descriptive statistic, Chi-square, t-test and multiple logistic were applied for data analysis. Results : According to the findings, DAMA rate in the first half of the year was 1.82% and most of the patients were female, housekeeper, native of Tabriz, admitted to CCU, had basic and supplementary insurance, discharged in the morning with an average age of 53.33 years and an average length of stay of 3.15 days. The most frequent cause of DAMA was based on hospital condition by (48.47%). Other causes were related to the patients (39.40%) and the relevant hospital personnel (12.13%). Conclusion : Based on the findings of this study, risk factors for DAMA are age, basic insurance, supplemental insurance and hospital ward. The very important DAMA reasons are hospital condition and high costs of hospital. Hospitals can use contracts with various insurance companies and charitable organizations to reduce costs and decrease DAMA rate.